A Bloomwell Group analysis shows medical cannabis patient density in Germany is converging: southern states still report higher per-capita self-paying patient shares, while eastern states have registered the fastest growth since medical cannabis was removed from the Narcotics Act (BtMG) on April 1, 2024.
Bloomwell, a Frankfurt-based company, compared regional shares of self-paying medical cannabis patients to the national average after April 1, 2024. The highest relative shares were in Saarland (+29.6%), Bavaria (+27.6%), Rhineland-Palatinate (+17.9%), Hesse (+16.5%) and Baden-Württemberg (+14.4%). States below the national average included Brandenburg (-31.3%), Saxony (-28.3%), Saxony-Anhalt (-22.5%), Thuringia (-18.9%) and Mecklenburg-Western Pomerania (-18.2%).
The post-BtMG period produced marked increases in eastern states. Bloomwell converted patient counts to cases per 100,000 inhabitants and calculated growth factors for the period after April 1, 2024. Saxony-Anhalt led with a growth factor of 314, Mecklenburg-Western Pomerania reached 184, and Brandenburg climbed 118. By contrast, growth factors during the same period were 25 in Saarland and 17 in Bavaria. Those figures show faster relative increases in regions that previously lagged.
Bloomwell tracked changes over the most recent 12 months (July 2025–June 2026) to show continuation of that trend. Saxony-Anhalt’s share moved from -83.8% below the national average before the BtMG change to -9.7% for July 2025–June 2026. Bavaria’s advantage narrowed as well: it fell from 150.5% above the national average before April 1, 2024, to 12.1% above in the July 2025–June 2026 window.
Dr. Julian Wichmann, Co-Founder and Managing Director of Bloomwell GmbH, said digital tools have widened access. He noted that telemedicine and online prescription pathways are enabling patients in regions without many experienced prescribers to obtain legal medical cannabis care. Bloomwell reports that as legal access expands, illegal self-medication has decreased in those areas.
The analysis also tracks market pricing. Bloomwell reports average retail price for medical cannabis flower fell to €4 per gram in Q2 2026. The company calls this price compression consistent with maturing markets elsewhere in Europe and attributes it to increased supply and competition in the out-of-pocket segment.
That price trend clashes with current health-insurance reimbursement rules. Until a new law takes effect, German health insurers may reimburse up to €19 per gram for medical cannabis flower. Bloomwell’s co-founder and CEO, Niklas Kouparanis, said the gap between insurer reimbursement and market prices creates inefficiency. He added that Bloomwell has approached insurers to discuss more efficient care pathways but that legislative change is moving reimbursement policy instead of insurer practice. Kouparanis called proposed cuts in flower reimbursement in an “austerity law” illogical given the downward price trend in cash purchases and said the company remains open to cooperation with insurers.
Key takeaways from Bloomwell’s analysis: – Regional patient density is higher in southern Germany, but eastern states are increasing patient counts faster since BtMG removal. – Saxony-Anhalt recorded the largest relative growth (growth factor 314) after April 1, 2024; Mecklenburg-Western Pomerania (184) and Brandenburg (118) also rose quickly. – The southern advantages have narrowed: Bavaria’s lead dropped from 150.5% above average pre-BtMG removal to 12.1% above in July 2025–June 2026. – Average out-of-pocket price for cannabis flower fell to €4/g in Q2 2026, while insurer reimbursement levels remain far higher pending legal reform.
Bloomwell frames the pattern as a move toward nationwide normalization of legal medical cannabis access, driven in part by telemedicine and targeted information about legal digital therapy routes. The company recommends aligning reimbursement rules with current market prices to avoid disrupting care for chronically ill patients who rely on stable prescriptions.
Data in the report are regional comparisons of self-paying patient shares and calculated growth factors per 100,000 inhabitants. Bloomwell supplied the regional percentages and growth-factor figures cited above, and the time comparisons use April 1, 2024 as the policy-change baseline and July 2025–June 2026 as the latest 12-month comparison window.
For clinicians, policymakers and payers, Bloomwell’s figures quantify how regulatory change and digital access affect where patients obtain medical cannabis and how quickly demand shifts across regions. The analysis signals that pricing dynamics in patient-paid markets have outpaced current reimbursement rules, a gap that stakeholders will need to resolve to maintain stable access for patients who receive prescriptions under the public system.
